Selective ultrasound-guided nerve root block improves outcomes for discectomy in patients with cervical disc disease: a randomized, controlled, single-blinded study.

Autor:	Abdelrady MM; Department of Anesthesia and Intensive Care, Faculty of Medicine, New Valley University, El-Kharga, Egypt - marwarady-2012@hotmail.com.; Department of Anesthesia, Intensive Care and PAIN, University of Assiut, Assiut, Egypt - marwarady-2012@hotmail.com., Lam KH; The Board of Clinical Research, The Hong Kong Institute of Musculoskeletal Medicine, Kowloon, Hong Kong, China.; Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong, China.; Faculty of Medicine, University of Hong Kong, Pok Fu lam, Hong Kong, China.; Center for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan (ROC).; Center for Regional Anesthesia and Pain Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan (ROC)., Shabaan N; Department of Neurosurgery, Faculty of Medicine, University of Tanta, Tanta, Egypt., Hassanien M; Department of Rheumatology and Rehabilitation, Faculty of Medicine, University of Assiut, Assiut, Egypt., Mokbel E; Department of Neurosurgery, Faculty of Medicine, University of Tanta, Tanta, Egypt., Nada DW; Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, University of Tanta, Tanta, Egypt., El Sharkawy AM; Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, University of Tanta, Tanta, Egypt., Ramadan KM; Department of Radio-diagnosis, Faculty of Medicine, University of Tanta, Tanta, Egypt., Ghoraba Y; Department of Neurosurgery, Faculty of Medicine, University of Tanta, Tanta, Egypt., Allam AE; Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, University of Tanta, Tanta, Egypt.; Morphological Madrid Research Center (MoMarc), Madrid, Spain.; Council of The Interventional Clinical Neurophysiology Fellowship, Arab Board of Health Specializations, Ministry of Health, Baghdad, Iraq., Aboelfadl GM; Department of Anesthesia, Intensive Care and PAIN, University of Assiut, Assiut, Egypt.
Jazyk:	angličtina
Zdroj:	Minerva anestesiologica [Minerva Anestesiol] 2024 Sep; Vol. 90 (9), pp. 748-758.
DOI:	10.23736/S0375-9393.24.17989-8
Abstrakt:	Background: We hypothesized that ultrasound-guided selective nerve root block could play a role in the prediction of clinical outcomes in patients with multilevel cervical disease following selective anterior cervical discectomy and fusion. Methods: Patients were randomized to receive ultrasound-guided selected nerve root block as a diagnostic tool (study group) or not (control group), but both groups had surgery. Pain evaluation for arm and neck pain was recorded. The Visual Analog Scale (VAS) pain scores, Neck Disability Index, and MRI results were compared between groups. They were assessed every two weeks for three months, postoperatively. The percentage of patients who showed ≥ 50% reduction in their pain levels and a VAS rating of ≤2 was deemed an acceptable surgical outcome. Results: Patients in the study group had significantly lower VAS scores for pain intensity than control patients at nearly all periods. This baseline pain improved significantly in the study group. A more significant proportion of patients in the study group showed a ≥50% reduction in their pain scores from baseline at weeks four, eight, and 12, and this difference was significantly lower than in the control group (P<0.05). The study group improved significantly over baseline in Neck Disability Index scores compared to control patients. Patients were highly satisfied with no significant adverse events in the study group. Conclusions: In patients with multilevel cervical disease, ultrasound-guided selective nerve root block is an excellent, safe, non-radiating, and reliable test to determine the appropriate level for operation.
Databáze:	MEDLINE
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